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ADFP-2(R•v.=_I1-79)q <br /> Attach to Wisconsin Income Tax Schedule FC - <br /> ZONING CERTIFICATE — FARMLAND PRESERVATION ACT — STATE OF WISCONSIN <br /> Haig Thomas & Barbara <br /> (1) Name of Owner(s) (Last) (First) (Middle Initial) <br /> (2) Address <br /> R#1, 4558 STH 78, Black Earth, WI 53515 (3) Phone 767-2550 <br /> Town of Vermont Secs 2, 11 7-N 6-E Dane <br /> (4) Location of the land Town, Village,or City Section,Township, Range County <br /> (If part of the owner's farmland is located in another town, village, or city,please submit information about that farmland on a separate form.) <br /> EXCLUSIVE AGRICULTURAL ZONING <br /> Dane <br /> (5) has an exclusive agricultural zoning ordinance which has been certified <br /> (County,Town, Village or City) <br /> by the State Agricultural Lands Preservation Board. <br /> (6) If the land is located in a town, has the town adopted the county exclusive agricultural <br /> October 12,ng ord9ance? <br /> Yes X No Date of Town Approval <br /> (7) Does each structure or improvement on the land conform to the requirements of the exclusive agricultural zoning ordinance? <br /> Yes X No <br /> Land on which tax credit is claimed: <br /> (8) Parcel No. (from tax rolls) (9) Total Acres in parcel (10) Acres in Exclusive iv ive Ag. District <br /> -------- <br /> 0706-023-9890-3 2.2000 2.2000 <br /> 40.00 00 40.0000 <br /> 0706-024-9500-3 1.0000 1.0000 <br /> 0706-111-8090-6 2.5000 2.5000 <br /> 0706-111-8500-9 35.0000 35.0000 <br /> 07 06-024-9100-7 <br /> Total 80.70 Total 80.70 <br /> - <br /> AGRICULTURAL PRESERVATION PLAN <br /> (11) - Dane County has adopted an agricultural preservation plan which was certified <br /> (date) 12/4/81 by the State Agricultural Lands Preservation Board. Is all of the owner/applicant farmland <br /> located in an agricultural preservation district under the certified county preservation plan? <br /> Yes No If NO, how many acres are in the preservation district? <br /> CERTIFICATION <br /> Program Year - <br /> Signature of Zoning Authority: <br /> Title: <br /> ZONING ADMINISTRATOR Date: <br /> --- <br /> RE-CERTIFICATION • <br /> (Note:If any of the above information has changed,please submit a new zoning certificate.) <br /> The undersigned hereby certifies that the information contained on this form is true and correct on the most recent date shown below.•1 Title Date Program Year <br /> Signature of Zoning Authority <br /> 2. _ <br /> Title —_- Date Program Year <br /> Signature of Zoning Authority <br /> 3 Date Program Year <br /> Signature of Zoning Authority Title <br /> 4 — Date Program Year <br /> Signature of Zoning Authority Title <br /> (The land must tax in an exclusive <br /> in agricultural <br /> the Schedule FC when credit for which <br /> is filed with thee Wis claimed. <br /> nsin Department certificate, along <br /> with property tax bills,must be me <br />